Cell Therapy for the Enhancement of Bone Repair - Engineered Bone: Tissue Engineering Intelligence Unit - page 160

Figure 5. Radiograms of ulna treated with autologous BMSC loaded bioceramic cylinder. Bioceramic loaded
with autologous BMSC were used to treat a 16 year-old girl presenting a 4.0 cm traumatic bone loss at the
distal diaphysis of the ulna. Radiograms were taken 8 months after treatment. Radiogram reveals a good
callus formation along the implant and a good integration at the interface with the host bone.
to treat patients with substantial (4 to 7 cm) long bone defects. 25 In principle the study was
organized to directly transfer the information gained from the animal study in the clinics. The
patients selected for this clinical study had experienced previous traditional surgical treaments
with negative results and no therapeutic alternatives were envisaged. Autologous osteoprogenitors
were isolated from the iliac crest bone marrow aspirates of each individual patient and ex-
panded “ex vivo”. As soon as the appropriate number of cells was obtained in culture,
osteprogenitor cells were harvested and delivered in vivo vehicled by highly porous hydroxyla-
patite scaffolds. External fixation was initially provided for mechanical stability. An abundant
callus formation along the entire implant and a good integration at the interface with the host
bone was observed as soon as by the second month after implantation. All patients recovered
limb function between 6 and 15 months (Fig. 5). Using a traditional approach, the expected
recovery time would have been much longer, under the most favorable conditions and in the
absence of complications.
Conclusions
In this chapter we have presented an overview of the cell based strategy for the treatment of
skeletal lesions. We have seen the potential sources of osteoprogenitor cells and the basic ele-
ments required from the scaffolds for cell delivery. Experimental preclinical models and clinical
pilot studies using this approach are providing results of high interest and very promising. Still
the results are far from being considered optimal. Several problems have to be solved before
considering cell therapy a real alternative in the clinical setting.